Finasteride and Methadone Use and Risk of Advanced Hepatitis C Related Liver Disease
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- White, D.L., Hashmi, A., Ramsey, D.J. et al. Dig Dis Sci (2012) 57: 3004. doi:10.1007/s10620-012-2231-3
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We evaluated the association between two medications that alter bioavailable androgen levels, finasteride and methadone, and risk of advanced HCV-related liver disease.
Males have strikingly greater cirrhosis risk across disease etiologies, including hepatitis C virus (HCV) infection.
In a cross-sectional study in HCV+ male veterans, we determined medication use by up to 15-year medical record review, and hepatic pathology by the FibroSURE-ActiTest (F3/F4-F4, advanced vs. F0-F3, mild fibrosis; and A2/A3-A3, advanced vs. A0-A2, mild inflammation). We performed race-adjusted and race-stratified multivariate analyses.
Among 571 HCV+ males, 43 % were White and 57 % African-American. There were non-significant decreased risks with finasteride use (ORadj advanced fibrosis = 0.75, 95 % CI 0.39–1.45 and ORadj advanced inflammation = 0.74, 95 % CI 0.41–1.43). For methadone, there was a non-significant 41 % increased advanced fibrosis risk in Whites and 51 % reduced risk in AA. White male methadone-users had 2.1-fold excess advanced inflammation risk (p = 0.15).
Our preliminary study results suggest finasteride use is not significantly associated with a decreased risk of advanced hepatic fibrosis or inflammation in HCV+ males. The ethnically-divergent results for methadone associated fibrosis risk and finding of potentially increased inflammation risk in White males suggests the need for additional research.
KeywordsHepatologyEpidemiologySex hormonesUrologyDrug addiction
Hepatitis C virus